中国晚期胃癌的诊疗现状
摘要
胃癌是中国较常见的恶性肿瘤之一,晚期胃癌严重威胁着人们的健康。目前晚期胃癌的定义按临床诊断和病理诊断进一步细分,过去的统计资料已无法充分反映国内晚期胃癌的状况。为此,本文从定义变化、分期迁移、流行病学、临床表现、病理类型、临床表型几个方面,重新整理及回顾了中国晚期胃癌的临床特征,并且总结了国内外治疗的研究进展。全身化疗仍然是中国晚期胃癌治疗的基石,但治疗模式早已开始向多学科综合治疗转变。转化治疗、手术治疗、放射治疗、靶向治疗、免疫治疗在晚期胃癌中有广阔前景。
引文
[1] Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2):115-132.
[2] Edge S, Byrd DR, Compton CC, et al. AJCC Cancer Staging Handbook[M]. 7th ed. America:Springer-Verlag New York, 2010:117-126.
[3] Amin MB, Edge S, Greene F, et al. AJCC Cancer Staging Manual[M]. 8th ed. America:Springer International Publishing, 2017:203-220.
[4] Qiu MZ, Wang ZX, Zhou YX, et al. Proposal for a new TNM stage based on the 7(th)and 8(th)American Joint Committee on Cancer pTNM Staging Classification for Gastric Cancer[J]. J Cancer, 2018, 9(suppl_1):3570-3576.
[5]宗杰,王岩,徐建明,等.影响晚期胃癌患者疗效和预后的相关因素分析[J].临床肿瘤学杂志, 2012, 17(8):721-725.
[6] Peng CW, Wang LW, Zeng WJ, et al. Evaluation of the staging systems for gastric cancer[J]. J Surg Oncol, 2013, 108(2):93-105.
[7] Sun Z, Wang ZN, Zhu Z, et al. Evaluation of the seventh edition of American Joint Committee on Cancer TNM staging system for gastric cancer:results from a Chinese monoinstitutional study[J]. Ann Surg Oncol, 2012, 19(6):1918-1927.
[8] Wang W, Li YF, Sun XW, et al. Prognosis of 980 patients with gastric cancer after surgical resection[J]. Chin J Cancer, 2010, 29(11):923-930.
[9] Wang W, Zheng C, Fang C, et al. Time trends of clinicopathologic features and surgical treatment for gastric cancer:results from 2 high-volume institutions in southern China[J]. Surgery, 2015, 158(6):1590-1597.
[10] Ji X, Bu ZD, Yan Y, et al. The 8th edition of the American Joint Committee on Cancer tumor-node-metastasis staging system for gastric cancer is superior to the 7th edition:results from a Chinese mono-institutional study of 1663 patients[J]. Gastric Cancer, 2018, 21(4):643-652.
[11] Lu J, Zheng CH, Cao LL, et al. Comparison of the 7th and8th editions of the American joint committee on cancer TNM classification for patients with stage III gastric cancer[J]. Oncotarget, 2017, 8(48):83555-83562.
[12]王喜,吴春晓,郑莹,等.上海市区胃癌发病的时间趋势和特点分析[J].中华流行病学杂志, 2007, 28(9):875-880.
[13] Nashimoto A, Akazawa K, Isobe Y, et al. Gastric cancer treated in 2002 in Japan:2009 annual report of the JGCA nationwide registry[J]. Gastric Cancer, 2013, 16(1):1-27.
[14] Wang W, Sun XW, Li CF, et al. Comparison of the 6th and7th editions of the UICC TNM staging system for gastric cancer:results of a Chinese single-institution study of 1,503 patients[J]. Ann Surg Oncol, 2011, 18(4):1060-1067.
[15]张鹏,徐岩,郭江宁,等.第6版与第7版TNM分期对胃癌患者预后预测的比较分析[J].现代肿瘤医学, 2014, 22(3):597-600.
[16]沈丹平,倪醒之,赫超,等.不同TNM分期标准在胃癌患者预后评估中的价值[J].胃肠病学, 2012, 17(9):536-539.
[17] Gu H, Li D, Zhu H, et al. The prognostic efficacy and improvements of the 7th edition Union for International Cancer Control tumor-node-metastasis classifications for Chinese patients with gastric cancer:results based on a retrospective three-decade population study[J]. Tumor Biol,2017, 39(3):101042831769454.
[18]任意,付蔚华,李卫东,等.胃癌第7版TNM分期的临床应用[J].中国中西医结合外科杂志, 2012, 18(2):114-116.
[19]宋卫峰,姚丽君,裘正军,等. AJCC第7版与第6版胃癌TNM分期的比较:一项基于预后分析的918例中国胃癌人群的回顾性研究[J].肿瘤, 2012, 32(8):615-621.
[20]李克兵.老年胃癌与中、青年胃癌的临床表现、病理特征的比较及预后分析[J].安徽医药, 2013, 17(2):285-286.
[21]林明晖,刘崇梅.不同年龄组中晚期胃癌的临床病理特点对比分析[J].中外健康文摘, 2011, 8(18):125-126.
[22]王松柏.不同年龄组中晚期胃癌的内镜及临床特点对比分析[J].临床消化病杂志, 2011, 23(1):50-51.
[23]吴春晓,郑莹,鲍萍萍,等.上海市胃癌发病流行现况与时间趋势分析[J].外科理论与实践, 2008, 13(1):24-29.
[24]王曼华,刘伯新,张玉华,等.不同性别青年胃癌患者的临床病理特点分析[J].肿瘤基础与临床, 2013, 26(3):228-230.
[25]唐世孝,邓明明,邹义君. 804例胃癌的临床分析[J].重庆医学, 2002, 31(9):821-823.
[26]王思平,朱艳.胃镜诊断胃癌1371例临床分析[J].实用临床医学, 2010, 11(3):45-48.
[27]孙秀华,刘柳,何红梅,等. 105例中晚期胃癌综合治疗的疗效及预后因素分析[J].大连医科大学学报, 2014, 36(4):355-359.
[28]陈序泉. 76例晚期胃癌临床特点分析[J].实用癌症杂志,1990, 5(4):284-285.
[29]程荣华,夏维超,代传绍,等.中晚期胃癌的综合治疗(摘要)[J].浙江肿瘤通讯, 1987(S1):102.
[30] Bosman FT, Carneiro F, Hruban RH, et al. WHO classification of tumours of the digestive system[M]. Geneva:World Health Organization, 2010:417.
[31]程国雄,郭庆渠,陈国锋,等. 17例胃髓样癌临床特征及远期生存分析[J].浙江医学, 2016, 39(19):1611-1613.
[32]周杰,滕晓东.胃淋巴上皮瘤样癌的临床病理特点及文献复习[J].中华病理学杂志, 2013, 42(11):758-759.
[33]李斌,孙琳,王晓娜,等. 42例原发性胃腺鳞癌的临床病理特征与预后分析[J].中华胃肠外科杂志, 2017, 20(2):207-212.
[34]裴炜,张海增,石素胜,等.原发性胃腺鳞癌11例临床病理分析[J].实用癌症杂志, 2008, 23(4):369-371.
[35]董淑晓,訾力,亓健,等.原发性胃鳞癌的临床病理特点[J].中国临床医生, 2011,(11):42-43.
[36]李永峰,刘崇,侯滨,等.原发性胃鳞状细胞癌17例临床病理分析[J].中华临床医师杂志(电子版), 2011, 5(15):4523-4525.
[37]李小毅,钟定荣,刘洪沨,等.胃肝样腺癌11例分析[J].癌症进展, 2012, 10(2):182-186; 198.
[38] Roberts CC, Colby TV, Batts KP. Carcinoma of the Stomach with hepatocyte differentiation(hepatoid adenocarcinoma)[J]. Mayo Clin Proc, 1997, 72(12):1154-1160.
[39]金鑫,花荣,曹晖,等.胃肝样腺癌临床特点与诊治分析[J].外科理论与实践, 2009, 14(3):374-376.
[40]茅翔,罗奋,陈宗祐,等.提高对胃肝样腺癌和产甲胎蛋白胃癌的认识[J].中华肿瘤杂志, 2015, 37(6):401-403.
[41]姚鲁田,徐惠绵.胃肝样腺癌的临床特征与预后[J].中华胃肠外科杂志, 2014, 17(2):196-200.
[42]杨亚男.晚期胃癌一线化疗疗效与安全性及预后相关因素的单中心回顾性研究[D].济南:山东大学, 2016.
[43] Lu M, Yang Z, Feng Q, et al. The characteristics and prognostic value of signet ring cell histology in gastric cancer:A retrospective cohort study of 2199 consecutive patients[J]. Medicine(Baltimore), 2016, 95(27):e4052.
[44] Kwon KJ, Shim KN, Song EM, et al. Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the stomach[J]. Gastric Cancer, 2014, 17(1):43-53.
[45]徐礼鹏,叶晓兵,赵文英,等.胃印戒细胞癌的临床病理特征及预后分析[J].皖南医学院学报, 2016, 35(1):30-33.
[46] Jiang CG, Wang ZN, Sun Z, et al. Clinicopathologic characteristics and prognosis of signet ring cell carcinoma of the stomach:results from a Chinese mono-institutional study[J]. J Surg Oncol, 2011, 103(7):700-703.
[47]崔景利,梁寒,邓靖宇,等.胃印戒细胞癌的临床病理特点和预后分析[J].中华肿瘤杂志, 2015, 37(5):367-370.
[48]王孟春,薛洪千,许东奎,等.胃癌肝转移外科治疗的临床分析[J].中华普通外科杂志, 2003, 18(4):23-24.
[49]周健国,赵东兵,赵建军,等.胃癌肝转移的肝切除治疗及预后分析[J].中华普通外科杂志, 2010, 25(10):785-788.
[50]严超,朱正纲,燕敏,等.多排CT对胃癌腹膜转移术前预测的单中心大宗病例研究[J].中华胃肠外科杂志, 2010,13(2):106-110.
[51]杨秋蒙,坂东悦郎,川村泰一,等. PET-CT诊断胃癌腹膜转移的临床价值[J].上海交通大学学报(医学版), 2007,27(5):573-576.
[52] Huang J, Luo H, Zhou C, et al. Yield of staging laparoscopy for incurable factors in chinese patients with advanced gastric cancer[J]. J Laparoendosc Adv Surg Tech A, 2018,28(1):19-24.
[53] Yamaguchi K, Yoshida K, Tanaka Y, et al. Conversion therapy for stage IV gastric cancer-the present and future[J].Transl Gastro Hepatol, 2016, 1:150.
[54] Park IH, Kim SY, Kim YW, et al. Clinical characteristics and treatment outcomes of gastric cancer patients with isolated para-aortic lymph node involvement[J]. Cancer Chemother Pharmacol, 2011, 67(1):127-136.
[55]徐瑞华,周志伟,沈琳,等.中国临床肿瘤学会(CSCO)原发性胃癌诊疗指南(2017.V1)[M].北京:人民卫生出版社, 2017:42-48.
[56] Kang YK, Kang WK, Shin DB, et al. Capecitabine/cisplatin versus 5-fluorouracil/cisplatin as first-line therapy in patients with advanced gastric cancer:a randomised phase III noninferiority trial[J]. Ann Oncol, 2009, 20(4):666-673.
[57] Cunningham D, Starling N, Rao S, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer[J]. N Engl J Med, 2008, 358(1):36-46.
[58] Kim GM, Jeung HC, Rha SY, et al. A randomized phase II trial of S-1-oxaliplatin versus capecitabine-oxaliplatin in advanced gastric cancer[J]. Eur J Cancer, 2012, 48(4):518-526.
[59] Van Cutsem E, Moiseyenko VM, Tjulandin S, et al. Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer:a report of the V325 study group[J]. J Clin Oncol, 2006, 24(31):4991-4997.
[60] Fuchs CS, Tomasek J, Yong CJ, et al. Ramucirumab monotherapy for previously treated advanced gastric or gastrooesophageal junction adenocarcinoma(REGARD):an international, randomised, multicentre, placebo-controlled,phase 3 trial[J]. Lancet, 2014, 383(9911):31-39.
[61] Wilke H, Muro K, Van Cutsem E, et al. Ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma(RAINBOW):a double-blind,randomised phase 3 trial[J]. Lancet Oncol, 2014, 15(11):1224-1235.
[62] Shitara K, Takashima A, Fujitani K, et al. Nab-paclitaxel versus solvent-based paclitaxel in patients with previously treated advanced gastric cancer(ABSOLUTE):an open-label, randomised, non-inferiority, phase 3 trial[J]. Lancet Gastroenterol Hepatol, 2017, 2(4):277-287.
[63] Hironaka S, Ueda S, Yasui H, et al. Randomized, open-Label, phase III study comparing irinotecan with paclitaxel in patients with advanced gastric cancer without severe peritoneal metastasis after failure of prior combination chemotherapy using fluoropyrimidine plus platinum:WJOG 4007 trial[J]. J Clin Oncol, 2013, 31(35):4438-4444.
[64] Graziano F, Catalano V, Baldelli AM, et al. A phase II study of weekly docetaxel as salvage chemotherapy for advanced gastric cancer[J]. Ann Oncol, 2000, 11(10):1263-1266.
[65] Ishigami H, Yamaguchi H, Yamashita H, et al. Surgery after intraperitoneal and systemic chemotherapy for gastric cancer with peritoneal metastasis or positive peritoneal cytology findings[J]. Gastric Cancer, 2017, 20(Suppl 1):128-134.
[66] Sato Y, Ohnuma H, Nobuoka T, et al. Conversion therapy for inoperable advanced gastric cancer patients by docetaxel, cisplatin, and S-1(DCS)chemotherapy:a multi-institutional retrospective study[J]. Gastric Cancer, 2017, 20(3):517-526.
[67] Han DS, Suh YS, Kong SH, et al. Outcomes of surgery aiming at curative resection in good responder to induction chemotherapy for gastric cancer with distant metastases[J]. J Surg Oncol, 2013, 107(5):511-516.
[68] Ito S, Oki E, Nakashima Y, et al. Clinical significance of adjuvant surgery following chemotherapy for patients with initially unresectable stage IV gastric cancer[J]. Anticancer Res, 2015, 35(1):401-406.
[69] Fujitani K, Yang HK, Mizusawa J, et al. Gastrectomy plus chemotherapy versus chemotherapy alone for advanced gastric cancer with a single non-curable factor(REGATTA):a phase 3, randomised controlled trial[J]. Lancet Oncol, 2016, 17(3):309-318.
[70] Sagawa T, Okagawa Y, Tamura F, et al. The prognostic factor and the optimal timing of conversion surgery in unresectable stage IV gastric cancer:A retrospective analysis[J]. J Clin Oncol, 2016, 34(4):78.
[71] Rudloff U, Langan RC, Mullinax JE, et al. Impact of maximal cytoreductive surgery plus regional heated intraperitoneal chemotherapy(HIPEC)on outcome of patients with peritoneal carcinomatosis of gastric origin:results of the GYMSSA trial[J]. J Surg Oncol, 2014, 110(3):275-284.
[72] Kim MS, Yoo SY, Cho CK, et al. Stereotactic body radiotherapy for isolated para-aortic lymph node recurrence after curative resection in gastric cancer[J]. J Korean Med Sci, 2009, 24(3):488-492.
[73] Moertel CG, Childs DS, Jr., Reitemeier RJ, et al. Combined 5-fluorouracil and supervoltage radiation therapy of locally unresectable gastrointestinal cancer[J]. Lancet,1969, 2(7626):865-867.
[74] Hazard L, O’connor J, Scaife C. Role of radiation therapy in gastric adenocarcinoma[J]. World J Gastroenterol,2006, 12(10):1511-1520.
[75] National Comprehensive Cancer Network. Gastric Cancer,NCCN Clinical Practice Guidelines in Oncology(Version5. 2017)[EB/OL].[2017-10-13]. https://www.nccn.org/professionals/physician_gls/pdf/gastric.pdf.
[76] Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2018(Japanese language)[M]. 5th ed. Japan:Kinbara Publishing Corporation, 2018:25-30.
[77] Leong T, Smithers BM, Haustermans K, et al. TOPGEAR:A Randomized, Phase III trial of perioperative ECF chemotherapy with or without preoperative chemoradiation for resectable gastric cancer:interim results from an international, intergroup trial of the AGITG, TROG, EORTC and CCTG[J]. Ann Surg Oncol, 2017, 24(8):2252-2258.
[78] Bang YJ, Van Cutsem E, Feyereislova A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer(ToGA):a phase 3,open-label, randomised controlled trial[J]. Lancet, 2010,376(9742):687-697.
[79] Nishikawa K, Takahashi T, Takaishi H, et al. Phase II study of the effectiveness and safety of trastuzumab and paclitaxel for taxane-and trastuzumab-na?ve patients with HER2-positive, previously treated, advanced, or recurrent gastric cancer(JFMC45-1102)[J]. Int J Cancer, 2017, 140(1):188-196.
[80] Thuss-Patience PC, Shah MA, Ohtsu A, et al. Trastuzumab emtansine versus taxane use for previously treated HER2-positive locally advanced or metastatic gastric or gastro-oesophageal junction adenocarcinoma(GATSBY):an international randomised, open-label, adaptive, phase 2/3 study[J]. Lancet Oncol, 2017, 18(5):640-653.
[81] Tabernero J, Hoff PM, Shen L, et al. Pertuzumab(P)plus trastuzumab(H)plus chemotherapy(CT)for HER2-positive metastatic gastric or gastro-oesophageal junction cancer(mGC/GEJC):final analysis of a phase III study(JACOB)[J]. Ann Oncol, 2017, 28(suppl_5).
[82] Li J, Qin S, Xu J, et al. Randomized, double-blind, placebo-controlled phase III trial of apatinib in patients with chemotherapy-refractory advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction[J]. J Clin Oncol, 2016, 34(13):1448-1454.
[83] Fuchs CS, Doi T, Jang RW, et al. Safety and efficacy of pembrolizumab monotherapy in patients with previously treated advanced gastric and gastroesophageal junction cancer:phase 2 clinical KEYNOTE-059 trial[J]. JAMA Oncol, 2018, 4(5):e180013.
[84] Muro K, Fuchs CS, Jang RWJ, et al. KEYNOTE-059 cohort 1:Pembrolizumab(Pembro)monotherapy in previously treated advanced gastric or gastroesophageal junction(G/GEJ)cancer in patients(Pts)with PD-L1+tumorsAsian subgroup analysis[J]. J Clin Oncol, 2018, 36(4_suppl):723.
[85] Kang YK, Boku N, Satoh T, et al. Nivolumab in patients with advanced gastric or gastro-oesophageal junction cancer refractory to, or intolerant of, at least two previous chemotherapy regimens(ONO-4538-12, ATTRACTION-2):a randomised, double-blind, placebo-controlled, phase 3trial[J]. Lancet, 2017, 390(10111):2461-2471.
[2] Edge S, Byrd DR, Compton CC, et al. AJCC Cancer Staging Handbook[M]. 7th ed. America:Springer-Verlag New York, 2010:117-126.
[3] Amin MB, Edge S, Greene F, et al. AJCC Cancer Staging Manual[M]. 8th ed. America:Springer International Publishing, 2017:203-220.
[4] Qiu MZ, Wang ZX, Zhou YX, et al. Proposal for a new TNM stage based on the 7(th)and 8(th)American Joint Committee on Cancer pTNM Staging Classification for Gastric Cancer[J]. J Cancer, 2018, 9(suppl_1):3570-3576.
[5]宗杰,王岩,徐建明,等.影响晚期胃癌患者疗效和预后的相关因素分析[J].临床肿瘤学杂志, 2012, 17(8):721-725.
[6] Peng CW, Wang LW, Zeng WJ, et al. Evaluation of the staging systems for gastric cancer[J]. J Surg Oncol, 2013, 108(2):93-105.
[7] Sun Z, Wang ZN, Zhu Z, et al. Evaluation of the seventh edition of American Joint Committee on Cancer TNM staging system for gastric cancer:results from a Chinese monoinstitutional study[J]. Ann Surg Oncol, 2012, 19(6):1918-1927.
[8] Wang W, Li YF, Sun XW, et al. Prognosis of 980 patients with gastric cancer after surgical resection[J]. Chin J Cancer, 2010, 29(11):923-930.
[9] Wang W, Zheng C, Fang C, et al. Time trends of clinicopathologic features and surgical treatment for gastric cancer:results from 2 high-volume institutions in southern China[J]. Surgery, 2015, 158(6):1590-1597.
[10] Ji X, Bu ZD, Yan Y, et al. The 8th edition of the American Joint Committee on Cancer tumor-node-metastasis staging system for gastric cancer is superior to the 7th edition:results from a Chinese mono-institutional study of 1663 patients[J]. Gastric Cancer, 2018, 21(4):643-652.
[11] Lu J, Zheng CH, Cao LL, et al. Comparison of the 7th and8th editions of the American joint committee on cancer TNM classification for patients with stage III gastric cancer[J]. Oncotarget, 2017, 8(48):83555-83562.
[12]王喜,吴春晓,郑莹,等.上海市区胃癌发病的时间趋势和特点分析[J].中华流行病学杂志, 2007, 28(9):875-880.
[13] Nashimoto A, Akazawa K, Isobe Y, et al. Gastric cancer treated in 2002 in Japan:2009 annual report of the JGCA nationwide registry[J]. Gastric Cancer, 2013, 16(1):1-27.
[14] Wang W, Sun XW, Li CF, et al. Comparison of the 6th and7th editions of the UICC TNM staging system for gastric cancer:results of a Chinese single-institution study of 1,503 patients[J]. Ann Surg Oncol, 2011, 18(4):1060-1067.
[15]张鹏,徐岩,郭江宁,等.第6版与第7版TNM分期对胃癌患者预后预测的比较分析[J].现代肿瘤医学, 2014, 22(3):597-600.
[16]沈丹平,倪醒之,赫超,等.不同TNM分期标准在胃癌患者预后评估中的价值[J].胃肠病学, 2012, 17(9):536-539.
[17] Gu H, Li D, Zhu H, et al. The prognostic efficacy and improvements of the 7th edition Union for International Cancer Control tumor-node-metastasis classifications for Chinese patients with gastric cancer:results based on a retrospective three-decade population study[J]. Tumor Biol,2017, 39(3):101042831769454.
[18]任意,付蔚华,李卫东,等.胃癌第7版TNM分期的临床应用[J].中国中西医结合外科杂志, 2012, 18(2):114-116.
[19]宋卫峰,姚丽君,裘正军,等. AJCC第7版与第6版胃癌TNM分期的比较:一项基于预后分析的918例中国胃癌人群的回顾性研究[J].肿瘤, 2012, 32(8):615-621.
[20]李克兵.老年胃癌与中、青年胃癌的临床表现、病理特征的比较及预后分析[J].安徽医药, 2013, 17(2):285-286.
[21]林明晖,刘崇梅.不同年龄组中晚期胃癌的临床病理特点对比分析[J].中外健康文摘, 2011, 8(18):125-126.
[22]王松柏.不同年龄组中晚期胃癌的内镜及临床特点对比分析[J].临床消化病杂志, 2011, 23(1):50-51.
[23]吴春晓,郑莹,鲍萍萍,等.上海市胃癌发病流行现况与时间趋势分析[J].外科理论与实践, 2008, 13(1):24-29.
[24]王曼华,刘伯新,张玉华,等.不同性别青年胃癌患者的临床病理特点分析[J].肿瘤基础与临床, 2013, 26(3):228-230.
[25]唐世孝,邓明明,邹义君. 804例胃癌的临床分析[J].重庆医学, 2002, 31(9):821-823.
[26]王思平,朱艳.胃镜诊断胃癌1371例临床分析[J].实用临床医学, 2010, 11(3):45-48.
[27]孙秀华,刘柳,何红梅,等. 105例中晚期胃癌综合治疗的疗效及预后因素分析[J].大连医科大学学报, 2014, 36(4):355-359.
[28]陈序泉. 76例晚期胃癌临床特点分析[J].实用癌症杂志,1990, 5(4):284-285.
[29]程荣华,夏维超,代传绍,等.中晚期胃癌的综合治疗(摘要)[J].浙江肿瘤通讯, 1987(S1):102.
[30] Bosman FT, Carneiro F, Hruban RH, et al. WHO classification of tumours of the digestive system[M]. Geneva:World Health Organization, 2010:417.
[31]程国雄,郭庆渠,陈国锋,等. 17例胃髓样癌临床特征及远期生存分析[J].浙江医学, 2016, 39(19):1611-1613.
[32]周杰,滕晓东.胃淋巴上皮瘤样癌的临床病理特点及文献复习[J].中华病理学杂志, 2013, 42(11):758-759.
[33]李斌,孙琳,王晓娜,等. 42例原发性胃腺鳞癌的临床病理特征与预后分析[J].中华胃肠外科杂志, 2017, 20(2):207-212.
[34]裴炜,张海增,石素胜,等.原发性胃腺鳞癌11例临床病理分析[J].实用癌症杂志, 2008, 23(4):369-371.
[35]董淑晓,訾力,亓健,等.原发性胃鳞癌的临床病理特点[J].中国临床医生, 2011,(11):42-43.
[36]李永峰,刘崇,侯滨,等.原发性胃鳞状细胞癌17例临床病理分析[J].中华临床医师杂志(电子版), 2011, 5(15):4523-4525.
[37]李小毅,钟定荣,刘洪沨,等.胃肝样腺癌11例分析[J].癌症进展, 2012, 10(2):182-186; 198.
[38] Roberts CC, Colby TV, Batts KP. Carcinoma of the Stomach with hepatocyte differentiation(hepatoid adenocarcinoma)[J]. Mayo Clin Proc, 1997, 72(12):1154-1160.
[39]金鑫,花荣,曹晖,等.胃肝样腺癌临床特点与诊治分析[J].外科理论与实践, 2009, 14(3):374-376.
[40]茅翔,罗奋,陈宗祐,等.提高对胃肝样腺癌和产甲胎蛋白胃癌的认识[J].中华肿瘤杂志, 2015, 37(6):401-403.
[41]姚鲁田,徐惠绵.胃肝样腺癌的临床特征与预后[J].中华胃肠外科杂志, 2014, 17(2):196-200.
[42]杨亚男.晚期胃癌一线化疗疗效与安全性及预后相关因素的单中心回顾性研究[D].济南:山东大学, 2016.
[43] Lu M, Yang Z, Feng Q, et al. The characteristics and prognostic value of signet ring cell histology in gastric cancer:A retrospective cohort study of 2199 consecutive patients[J]. Medicine(Baltimore), 2016, 95(27):e4052.
[44] Kwon KJ, Shim KN, Song EM, et al. Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the stomach[J]. Gastric Cancer, 2014, 17(1):43-53.
[45]徐礼鹏,叶晓兵,赵文英,等.胃印戒细胞癌的临床病理特征及预后分析[J].皖南医学院学报, 2016, 35(1):30-33.
[46] Jiang CG, Wang ZN, Sun Z, et al. Clinicopathologic characteristics and prognosis of signet ring cell carcinoma of the stomach:results from a Chinese mono-institutional study[J]. J Surg Oncol, 2011, 103(7):700-703.
[47]崔景利,梁寒,邓靖宇,等.胃印戒细胞癌的临床病理特点和预后分析[J].中华肿瘤杂志, 2015, 37(5):367-370.
[48]王孟春,薛洪千,许东奎,等.胃癌肝转移外科治疗的临床分析[J].中华普通外科杂志, 2003, 18(4):23-24.
[49]周健国,赵东兵,赵建军,等.胃癌肝转移的肝切除治疗及预后分析[J].中华普通外科杂志, 2010, 25(10):785-788.
[50]严超,朱正纲,燕敏,等.多排CT对胃癌腹膜转移术前预测的单中心大宗病例研究[J].中华胃肠外科杂志, 2010,13(2):106-110.
[51]杨秋蒙,坂东悦郎,川村泰一,等. PET-CT诊断胃癌腹膜转移的临床价值[J].上海交通大学学报(医学版), 2007,27(5):573-576.
[52] Huang J, Luo H, Zhou C, et al. Yield of staging laparoscopy for incurable factors in chinese patients with advanced gastric cancer[J]. J Laparoendosc Adv Surg Tech A, 2018,28(1):19-24.
[53] Yamaguchi K, Yoshida K, Tanaka Y, et al. Conversion therapy for stage IV gastric cancer-the present and future[J].Transl Gastro Hepatol, 2016, 1:150.
[54] Park IH, Kim SY, Kim YW, et al. Clinical characteristics and treatment outcomes of gastric cancer patients with isolated para-aortic lymph node involvement[J]. Cancer Chemother Pharmacol, 2011, 67(1):127-136.
[55]徐瑞华,周志伟,沈琳,等.中国临床肿瘤学会(CSCO)原发性胃癌诊疗指南(2017.V1)[M].北京:人民卫生出版社, 2017:42-48.
[56] Kang YK, Kang WK, Shin DB, et al. Capecitabine/cisplatin versus 5-fluorouracil/cisplatin as first-line therapy in patients with advanced gastric cancer:a randomised phase III noninferiority trial[J]. Ann Oncol, 2009, 20(4):666-673.
[57] Cunningham D, Starling N, Rao S, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer[J]. N Engl J Med, 2008, 358(1):36-46.
[58] Kim GM, Jeung HC, Rha SY, et al. A randomized phase II trial of S-1-oxaliplatin versus capecitabine-oxaliplatin in advanced gastric cancer[J]. Eur J Cancer, 2012, 48(4):518-526.
[59] Van Cutsem E, Moiseyenko VM, Tjulandin S, et al. Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer:a report of the V325 study group[J]. J Clin Oncol, 2006, 24(31):4991-4997.
[60] Fuchs CS, Tomasek J, Yong CJ, et al. Ramucirumab monotherapy for previously treated advanced gastric or gastrooesophageal junction adenocarcinoma(REGARD):an international, randomised, multicentre, placebo-controlled,phase 3 trial[J]. Lancet, 2014, 383(9911):31-39.
[61] Wilke H, Muro K, Van Cutsem E, et al. Ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma(RAINBOW):a double-blind,randomised phase 3 trial[J]. Lancet Oncol, 2014, 15(11):1224-1235.
[62] Shitara K, Takashima A, Fujitani K, et al. Nab-paclitaxel versus solvent-based paclitaxel in patients with previously treated advanced gastric cancer(ABSOLUTE):an open-label, randomised, non-inferiority, phase 3 trial[J]. Lancet Gastroenterol Hepatol, 2017, 2(4):277-287.
[63] Hironaka S, Ueda S, Yasui H, et al. Randomized, open-Label, phase III study comparing irinotecan with paclitaxel in patients with advanced gastric cancer without severe peritoneal metastasis after failure of prior combination chemotherapy using fluoropyrimidine plus platinum:WJOG 4007 trial[J]. J Clin Oncol, 2013, 31(35):4438-4444.
[64] Graziano F, Catalano V, Baldelli AM, et al. A phase II study of weekly docetaxel as salvage chemotherapy for advanced gastric cancer[J]. Ann Oncol, 2000, 11(10):1263-1266.
[65] Ishigami H, Yamaguchi H, Yamashita H, et al. Surgery after intraperitoneal and systemic chemotherapy for gastric cancer with peritoneal metastasis or positive peritoneal cytology findings[J]. Gastric Cancer, 2017, 20(Suppl 1):128-134.
[66] Sato Y, Ohnuma H, Nobuoka T, et al. Conversion therapy for inoperable advanced gastric cancer patients by docetaxel, cisplatin, and S-1(DCS)chemotherapy:a multi-institutional retrospective study[J]. Gastric Cancer, 2017, 20(3):517-526.
[67] Han DS, Suh YS, Kong SH, et al. Outcomes of surgery aiming at curative resection in good responder to induction chemotherapy for gastric cancer with distant metastases[J]. J Surg Oncol, 2013, 107(5):511-516.
[68] Ito S, Oki E, Nakashima Y, et al. Clinical significance of adjuvant surgery following chemotherapy for patients with initially unresectable stage IV gastric cancer[J]. Anticancer Res, 2015, 35(1):401-406.
[69] Fujitani K, Yang HK, Mizusawa J, et al. Gastrectomy plus chemotherapy versus chemotherapy alone for advanced gastric cancer with a single non-curable factor(REGATTA):a phase 3, randomised controlled trial[J]. Lancet Oncol, 2016, 17(3):309-318.
[70] Sagawa T, Okagawa Y, Tamura F, et al. The prognostic factor and the optimal timing of conversion surgery in unresectable stage IV gastric cancer:A retrospective analysis[J]. J Clin Oncol, 2016, 34(4):78.
[71] Rudloff U, Langan RC, Mullinax JE, et al. Impact of maximal cytoreductive surgery plus regional heated intraperitoneal chemotherapy(HIPEC)on outcome of patients with peritoneal carcinomatosis of gastric origin:results of the GYMSSA trial[J]. J Surg Oncol, 2014, 110(3):275-284.
[72] Kim MS, Yoo SY, Cho CK, et al. Stereotactic body radiotherapy for isolated para-aortic lymph node recurrence after curative resection in gastric cancer[J]. J Korean Med Sci, 2009, 24(3):488-492.
[73] Moertel CG, Childs DS, Jr., Reitemeier RJ, et al. Combined 5-fluorouracil and supervoltage radiation therapy of locally unresectable gastrointestinal cancer[J]. Lancet,1969, 2(7626):865-867.
[74] Hazard L, O’connor J, Scaife C. Role of radiation therapy in gastric adenocarcinoma[J]. World J Gastroenterol,2006, 12(10):1511-1520.
[75] National Comprehensive Cancer Network. Gastric Cancer,NCCN Clinical Practice Guidelines in Oncology(Version5. 2017)[EB/OL].[2017-10-13]. https://www.nccn.org/professionals/physician_gls/pdf/gastric.pdf.
[76] Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2018(Japanese language)[M]. 5th ed. Japan:Kinbara Publishing Corporation, 2018:25-30.
[77] Leong T, Smithers BM, Haustermans K, et al. TOPGEAR:A Randomized, Phase III trial of perioperative ECF chemotherapy with or without preoperative chemoradiation for resectable gastric cancer:interim results from an international, intergroup trial of the AGITG, TROG, EORTC and CCTG[J]. Ann Surg Oncol, 2017, 24(8):2252-2258.
[78] Bang YJ, Van Cutsem E, Feyereislova A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer(ToGA):a phase 3,open-label, randomised controlled trial[J]. Lancet, 2010,376(9742):687-697.
[79] Nishikawa K, Takahashi T, Takaishi H, et al. Phase II study of the effectiveness and safety of trastuzumab and paclitaxel for taxane-and trastuzumab-na?ve patients with HER2-positive, previously treated, advanced, or recurrent gastric cancer(JFMC45-1102)[J]. Int J Cancer, 2017, 140(1):188-196.
[80] Thuss-Patience PC, Shah MA, Ohtsu A, et al. Trastuzumab emtansine versus taxane use for previously treated HER2-positive locally advanced or metastatic gastric or gastro-oesophageal junction adenocarcinoma(GATSBY):an international randomised, open-label, adaptive, phase 2/3 study[J]. Lancet Oncol, 2017, 18(5):640-653.
[81] Tabernero J, Hoff PM, Shen L, et al. Pertuzumab(P)plus trastuzumab(H)plus chemotherapy(CT)for HER2-positive metastatic gastric or gastro-oesophageal junction cancer(mGC/GEJC):final analysis of a phase III study(JACOB)[J]. Ann Oncol, 2017, 28(suppl_5).
[82] Li J, Qin S, Xu J, et al. Randomized, double-blind, placebo-controlled phase III trial of apatinib in patients with chemotherapy-refractory advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction[J]. J Clin Oncol, 2016, 34(13):1448-1454.
[83] Fuchs CS, Doi T, Jang RW, et al. Safety and efficacy of pembrolizumab monotherapy in patients with previously treated advanced gastric and gastroesophageal junction cancer:phase 2 clinical KEYNOTE-059 trial[J]. JAMA Oncol, 2018, 4(5):e180013.
[84] Muro K, Fuchs CS, Jang RWJ, et al. KEYNOTE-059 cohort 1:Pembrolizumab(Pembro)monotherapy in previously treated advanced gastric or gastroesophageal junction(G/GEJ)cancer in patients(Pts)with PD-L1+tumorsAsian subgroup analysis[J]. J Clin Oncol, 2018, 36(4_suppl):723.
[85] Kang YK, Boku N, Satoh T, et al. Nivolumab in patients with advanced gastric or gastro-oesophageal junction cancer refractory to, or intolerant of, at least two previous chemotherapy regimens(ONO-4538-12, ATTRACTION-2):a randomised, double-blind, placebo-controlled, phase 3trial[J]. Lancet, 2017, 390(10111):2461-2471.